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Dupuytren’s Contracture: Transverse Palmar Incision

- Discussion:
    - for pts who have severe involvement, w/MP & PIP Joint contractures as well as fixation of palmar skin & involvement of multiple rays;
    - often transverse incisions are left open (McCash (1964) or are covered w/ a full thickness skin graft;
    - transverse incision across palm beginning at level just proximal to metacarpal heads & paralleling distal palmar crease w/extension 
           proximally over hypothenar eminence from little finger provides excellent exposure;
    - separate zigzag or z-plasty incisions are used to remove diseased digital fascia, & these incisions may be connected to transverse 
           palmar wound, if necessary

- Case Example: transverse palmar incision followed by FTSG

Wound complications in the surgical management of Dupuytren's contracture: a comparison of operative incisions.

Surgical alternatives in Dupuytren's contracture.